The journal of the Japanese Practical Surgeon Society
Online ISSN : 2189-2075
Print ISSN : 0386-9776
ISSN-L : 0386-9776
APPLICATION AND PROBLEMS OF BLUNT DISSECTION WITHOUT THORACOTOMY FOR CARCINOMA OF THORACIC ESOPHAGUS
Tatsuyuki KAWANOKunihide YOSHINOTohru TAKIGUCHIShigeru YAMAZAKIToshifumi TAENAKAKatsuo SHIMOJUTomoyuki SUZUKIKagami NAGAIMitsuo ENDO
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1987 Volume 48 Issue 11 Pages 1784-1790

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Abstract
Sixteen cases of intrathoracic esophageal lesion on whom blunt dissection was carried out without thoracotomy were evaluated retrospectively for operative safety and adequacy of indications for intrathoracic esophageal carcinoma.
Results were as follows:
1) Blunt dissection without thoracotomy is safe in cases of intrathoracic esophageal lesion except for those with severe adventitial changes.
2) Blunt dissection is applicable for cases of reduced pulmonary function and those at high risk; therefore, the resectability rate may be increased. Blunt dissection should be considered if resection under thoracotomy is impossible, especially in cases in which cancer invasion is limitted to the lamina propria mucosae, because curative resection can be expected.
3) In other intrathoracic carcinoma cases in which resection under thoracotomy is not suitable because of impaired general condition or distant organ metastasis, blunt dissection may be acceptable given considerations of cancer reduction and/or avoiding such complications as bleeding. It is also important to compare the benefits and disadvantages of blunt dissection with those of other therapeutic methods for these cases in terms of the patient's prognosis and quality of life.
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© Japan Surgical Association
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